ArticleBMJ quality & safety2016
The Healthcare Complaints Analysis Tool: development and reliability testing of a method for service monitoring and organisational learning.
Article in BMJ quality & safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.
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Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Understanding healthcare professionals' responses to patient complaints in secondary and tertiary care in the UK: A systematic review and behavioural analysis using the Theoretical Domains Framework.Health research policy and systems · 2024Pooled it
- Characterising patient complaints in out-of-hours general practice: a retrospective cohort study in Ireland.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- What can patients tell us about the quality and safety of hospital care? Findings from a UK multicentre survey study.BMJ quality & safety · 2018Trial
- Expectations of dog and cat owners when dealing with veterinary errors and the emotional impact of such errors.The Veterinary record · 2026Article
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- It takes (at least) two to tango: comparing the affordances of two learner mistreatment reporting mechanisms.Canadian medical education journal · 2026Article
- Understanding Medication Errors Through Patient Complaints in a Danish University Hospital.Basic & clinical pharmacology & toxicology · 2026Article
- Compensation claims for chiropractic in Denmark 2013-2022.Chiropractic & manual therapies · 2026Article
- Beyond gratitude: a qualitative investigation of compliment letters received by a neonatology service.BMC health services research · 2026Article
- Patient complaints on nurse job satisfaction in primary health care clinics, Ehlanzeni District, South Africa.African journal of primary health care & family medicine · 2025Article
- From challenge to growth: Exploring physician narratives of patient complaints during residency.Medical education · 2025Review
- Pattern of unreported negative birth experiences in the maternity ward.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Stage-specific harm in early-stage hospitals in South Korea: a retrospective analysis using the healthcare complaints analysis tool.BMJ open · 2025Article
- Spatial-temporal analysis of patient complaints in Shanghai from 2015 to 2022.BMC health services research · 2025Article
- Developing Healthcare Complaints Analysis Tool for Health System: A Cross-Sectional Study.Health science reports · 2025Article
- Implementation of Patient Complaint Management Mechanisms for Quality Improvement in Maternal Health Services: Exploration of Provider Perspectives at Mkuranga District Hospital.International journal of women's health · 2025Article
- Performance of Large Language Models in Patient Complaint Resolution: Web-Based Cross-Sectional Survey.Journal of medical Internet research · 2024Article
- Customer Healthcare Complaints in Brazil Are Seldom about Medical Errors.International journal of environmental research and public health · 2024Review
- Assessing nourishment problems at a hospital: what can we learn from them?BMJ open quality · 2024Article
- From systematic complaint analysis to quality improvement in healthcare.BMJ open quality · 2024Article
Corrections and comments
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2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLetters of complaint written by patients and their advocates reporting poor healthcare experiences represent an under-used data source. The lack of a method for extracting reliable data from these heterogeneous letters hinders their use for monitoring and learning. To address this gap, we report on the development and reliability testing of the Healthcare Complaints Analysis Tool (HCAT).
methodsHCAT was developed from a taxonomy of healthcare complaints reported in a previously published systematic review. It introduces the novel idea that complaints should be analysed in terms of severity. Recruiting three groups of educated lay participants (n=58, n=58, n=55), we refined the taxonomy through three iterations of discriminant content validity testing. We then supplemented this refined taxonomy with explicit coding procedures for seven problem categories (each with four levels of severity), stage of care and harm. These combined elements were further refined through iterative coding of a UK national sample of healthcare complaints (n= 25, n=80, n=137, n=839). To assess reliability and accuracy for the resultant tool, 14 educated lay participants coded a referent sample of 125 healthcare complaints.
resultsThe seven HCAT problem categories (quality, safety, environment, institutional processes, listening, communication, and respect and patient rights) were found to be conceptually distinct. On average, raters identified 1.94 problems (SD=0.26) per complaint letter. Coders exhibited substantial reliability in identifying problems at four levels of severity; moderate and substantial reliability in identifying stages of care (except for 'discharge/transfer' that was only fairly reliable) and substantial reliability in identifying overall harm.
conclusionsHCAT is not only the first reliable tool for coding complaints, it is the first tool to measure the severity of complaints. It facilitates service monitoring and organisational learning and it enables future research examining whether healthcare complaints are a leading indicator of poor service outcomes. HCAT is freely available to download and use.
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